MHA Today | October 17, 2016

October 17, 2016

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.

Information about the Nov. 8 election is available on the Your Vote Matters page of Missouri Health Matters. Hospitals can help educate their communities about the election using the resources on MHAnet.

MHA Distributes Medicare Proposed Episode Payment Model Analysis

The Centers for Medicare & Medicaid Services announced a newly proposed episode payment model, which rewards or penalizes hospitals based on their quality and cost of providing services for coronary artery bypass graft, acute myocardial infarction and surgical hip/femur fracture treatment excluding lower extremity joint replacement services. CMS is proposing to use the same 67 metropolitan statistical areas for the new SHFFT episodes and the current comprehensive care for joint replacement model. CMS also is proposing to select 98 MSAs from a list of 294 through a random sampling methodology. Although it is unknown which MSAs will be selected, MHA is releasing an analysis that will assist potentially eligible hospitals in understanding the program structure and their specific hospital costs. Policy and analytic studies are made available for download to authorized users of HIDI Analytic Advantage.®

HIDI has planned additional analytic offerings to support hospitals in managing episode-based payment model performance, including ongoing surveillance based on HIDI and CMS-supplied claims and predictive alerting to support early identification and management of episodes with escalated risk of complications, readmissions and excess utilization.

HIDI HealthStats — Adverse Childhood Experiences

The October issue of HIDI HealthStats reviews the importance of building resilience around trauma and adverse childhood experiences. The issue identifies high-risk communities in Missouri and Kansas. ACEs were identified in a foundational study conducted by the Centers for Disease Control and Prevention and Kaiser Permanente that linked traumatic events in childhood to individual health and well-being in adulthood. The researchers developed a survey that evaluated adult risk behavior, health status and disease against the presence of childhood experiences across several domains: psychological, physical or sexual abuse; witness of mother’s violent treatment; and household members who were drug or alcohol abusers, mentally ill or suicidal, or ever imprisoned. The study found strong statistical associations between the number of ACEs present and each adverse health and well-being measure evaluated in adulthood. The study concluded that adverse experiences in childhood produce a chain reaction of diminished physical and emotional well-being throughout the lifespan, and the risk increases substantially with the number of ACEs the individual underwent. From near to long-term, ACEs result in the following.

social, emotional and cognitive impairment

adoption of risky behaviors

disease, disability and social problems

premature death

To identify communities with children at risk of potentially experiencing ACEs and associated downstream health outcomes, a model was developed around the ACEs study framework using hospital discharge and census-based data inputs for Missouri, Kansas and St. Louis metro-area Illinois ZIP codes. A risk index was produced for each ZIP code with sufficient data using a latent variable modeling approach. All model data and risk scores are available at: http://bit.ly/2dBJIKt. The aim of this study is to inform resilient community initiatives and other community health stakeholders of potential strategies to optimize the allocation of scarce community health improvement interventional resources. Read the entire issue for more on what data were aggregated for the study.

The Commonwealth Fund Mongan Fellowship Seeks Applications

The Commonwealth Fund Mongan Fellowship is designed to prepare physicians for leadership roles in transforming health care delivery systems and promoting health policies and practices that improve access to high-performance health care for vulnerable populations, including racial and ethnic minorities and economically disadvantaged groups. Fellows will complete academic work leading to a Master of Public Health degree at the Harvard T.H. Chan School of Public Health and gain exposure to, and understanding of, major health issues facing vulnerable and disadvantaged populations through fellowship activities. The Fellowship also offers a Master of Public Administration degree at the Harvard Kennedy School to physicians already possessing an MPH. For application materials, information and other training opportunities, contact the program coordinator at 617/432-2922 or mfdp_cfmf@hms.harvard.edu.The application deadline for the 2017-2018 Fellowship is Thursday, Dec. 1.

State Office Recognizes Rural Health Day

The Missouri State Office of Rural Health is sponsoring the Missouri Rural Health Conference on Tuesday, Nov. 15, and Wednesday, Nov. 16, at the Hilton Garden Inn in Columbia, Mo. The conference is held in conjunction with the Get Link’d 2016 Health & Transportation Conference. This year’s keynote speakers are Brian Bauer of Hall and Render, and Paul Moore, Senior Health Policy Advisor to the Federal Office of Rural Health Policy. Registration is required and a preliminary agenda is available.